Stroke remains a leading cause of mortality, morbidity and disability with gradients in all three outcomes by race-ethnicity and gender. Lower SES groups, including Blacks and Hispanics, suffer a disproportionately high burden of risk, disability and death from stroke, myocardial infarction and associated vascular risk factors. Until recently there has been a dearth of Phase 2 and 3 clinical trials for stroke, and those that have been undertaken have mostly focused only on acute stroke treatment. Additionally, many of these trials were unable to meet trial enrollment targets and had poor recruitment of underrepresented minorities and women. As new stroke treatment approaches emerge, both from neuroscience laboratories and from epidemiologic cohort studies, rapid translation requires the efficient design and implementation of clinical trials in this area. We are responding to RFA-NS-13-011: NINDS Stroke Trials Network-Regional Coordinating Stroke Centers (RCC) with the overall aim to establish a collaborative network that brings together three major urban academic medical centers and their affiliates. The Centers bring with them three large CTSA's and an extensive network system to leverage clinical expertise and research infrastructure to provide multidisciplinary support to maximize the efficient development, promotion, and conduct of high quality multi- site clinical trials, with a focus on stroke prevention, treatment and rehabilitation/recovery in both adult and pediatric populations. The centers include the Albert Einstein College of Medicine (AECOM), Icahn School of Medicine at Mount Sinai (ISMMS), and New York University School of Medicine (NYU). Additionally, Hofstra-North Shore-Long Island Jewish Medical School and Health System together with their network institutions and affiliates. New York City Health and Hospitals Corporation (HHC) facilities; Continuum Health Partners facilities (Beth Israel Medical Center, St. Luke's/Roosevelt Hospital Center); and Maimonides Medical Center join NYCC-RCC as affiliate institutions. Three rehabilitation hospitals, including the preeminent Rusk Institute at NYU, Beth Abraham at Einstein and the Rehabilitation Center at ISMMS are also key network partners.